London Heart

9 things everybody should know about atrial fibrillation

Lots of things can cause a racing pulse – many completely harmless, like feeling nervous, getting a fright, or running for a bus! But a fast, irregular heartbeat can also be a sign of a condition called atrial fibrillation (AF), and this isn’t something you should ignore.

This week is Global AF Aware Week (November 20-26), an annual campaign by the AF Association to highlight the symptoms of atrial fibrillation and why it’s crucial people with it are properly diagnosed, because it’s leading cause of stroke – yet treatments for atrial fibrillation can be very effective

Here, leading London heart specialist Dr Syed Ahsan, outlines 9 key points about atrial fibrillation…

1. What is atrial fibrillation?

AF is an abnormal heart rhythm that occurs due to disruptions within the electrical signals in the heart’s left upper chamber – the part of your heart that receives oxygen-rich blood from your lungs. In a healthy heart, the upper chambers then pump this blood into the lower chambers, which then pump it into your arteries and around your body, but when AF occurs this system gets disrupted and blood can pool in the upper chambers.

2. It’s a major cause of stroke

When blood pools in the heart, clots can form, which could result in a stroke. “AF is the most common cause of stroke in this country, and strokes that occur as a result of AF tend to be much more severe, more debilitating, with a higher mortality rate than strokes from other causes,” says Syed.

3. But AF-related strokes are also highly preventable

“Preventing strokes in AF patients is actually very straightforward, with an anticoagulant or blood thinner,” says Syed. “As well as medication, some patients can be treated with a procedure called a catheter ablation, which involves passing a wire into the heart, essentially trying to cure the AF.” Treatment often depends on the severity and type of AF someone has – it normally starts with paroxysmal AF, “which means people have a normal heart rhythm most of the time with bouts of irregular rhythm”, and can develop into persistent AF, “where the heart’s beating irregularly all the time” – as well as how high somebody’s stroke risk is deemed to be.

4. AF is very common

Around 1.5 million people in the UK have atrial fibrillation. “One in 10 people aged over 65 in the UK will have AF,” says Syed. “And for all of us, there’s a one in four chance of developing AF in our lifetime.”

5. But thousands are unaware they’ve got it

“Often, people don’t even know they’ve got AF, it’s only picked up through a routine screening or when they’re being checked for other things,” notes Syed. It’s estimated as many as a third of people in UK with AF are undiagnosed – some only find out after suffering a stroke. But a simple pulse check can help detect an irregular heart rhythm. “If irregularities are found, people can be referred for further investigations, including ECGs,” adds Syed. “Although if people are only experiencing on-off episodes of irregular heartbeat, they may need to wear a heart monitor for a longer period.”

6. The symptoms aren’t always obvious

“Typically, the symptoms people get are a feeling of fast, irregular palpitations, or awareness of their heartbeat, but it can manifest in lots of different ways,” says Syed. Often, people will just not feel themselves or feel tired, or describe their symptoms as shortness of breath or dizziness.” Of course, palpitations are very common and don’t automatically mean there’s a problem with your heart, but it’s always sensible to get any symptoms looked at promptly.

7. AF can affect younger people too

Age is the biggest risk factor for atrial fibrillation – but that’s not to say it can’t affect younger people. “As you get older, your risk of developing AF increases,” says Syed. Typically, it’s older patients who are over 65, 75. But more and more commonly now we’re seeing younger patients with AF, and they can be as young as 18, 19, 20.”

8. The exact causes aren’t fully understood

Although it’s not entirely clear why some people get AF, there are some known risk factors and causes of atrial fibrillation that it’s useful to be aware of. “Drinking too much alcohol, having poorly controlled high blood pressure and diabetes or thyroid disorders; all these things can increase your risk of AF,” says Syed. Those with a family history of AF, or a history of other heart problems, also tend to be at greater risk.

9. Fit and healthy people can also get AF

While lifestyle factors can play a part, AF is “not entirely lifestyle dependant”. In fact, it can sometimes occur in people who are in good general health. “We also see it in athletes, and people who exercise a lot,” says Syed. The key message? Anybody who thinks their heart rate might be abnormal, should get it checked. “Often, all it takes is a quick pulse check,” adds Syed. “So it’s always best to get it checked.”